ArticleFrontiers in health services2026
A standardized educational implementation strategy improves operational Code Sepsis knowledge in a high-complexity hospital in Colombia.
Article in Frontiers in health services, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Timely recognition and early bundle-based care are essential to improve sepsis outcomes. However, implementation gaps persist in routine hospital practice, particularly in middle-income settings where multidisciplinary coordination and operational knowledge of institutional protocols are critical. This study evaluated the effect of a standardized educational strategy on immediate Code Sepsis knowledge among hospital personnel in a high-complexity hospital in Colombia. Methods: We conducted a single-group quasi-experimental before-and-after study in 2025 among clinical and non-clinical hospital personnel who voluntarily attended a 45-minute in-person multidisciplinary training session on the institutional Code Sepsis strategy. Participants completed a 12-item expert-reviewed assessment before and after intervention. Because one implementation-status item presented a postintervention response-format artifact, the primary outcome was an 11-item knowledge score ranging from 0 to 11. Strict linkage yielded 591 complete pre-post pairs. Paired score changes were evaluated using bootstrap confidence intervals, the Wilcoxon signed-rank test, and rank-biserial correlation. Item-level changes were assessed using McNemar's test with false discovery rate adjustment, while generalized estimating equations were used to estimate the overall postintervention change in the odds of a correct response. Results: The mean 11-item score increased from 5.80 to 9.22. The paired mean increase was 3.42 points (95% CI, 3.20-3.64), representing 31.1% of the total possible score range. The median paired increase was 3.0 points, and the rank-biserial correlation was 0.9646, indicating a very large favorable paired effect. Overall, 88.0% of participants improved, whereas 5.4% obtained a lower postintervention score. All 11 items improved after false discovery rate correction. Correct item-level responses increased from 52.7% to 83.8%, and postintervention assessments were associated with 5.63-fold higher odds of a correct response (95% CI, 5.05-6.28; Conclusions: A brief, standardized, multidisciplinary educational strategy was associated with a substantial and consistently favorable immediate improvement in operational Code Sepsis knowledge among hospital personnel. These findings reflect immediate knowledge acquisition and should not be extrapolated to long-term retention, changes in clinical practice, or patient outcomes.
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